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目的探讨肝脏局灶结节性增生(FNH)的临床特点和诊断手段。方法对1988—2007年近20年间我国公开期刊发表的关于FNH的报道85篇,加上笔者近6年来收治的经术后病理证实为FNH的患者12例,共1 275例临床资料进行回顾性分析。结果FNH多见于20~50岁患者,平均35.4岁,男女比例1.22∶1.00(700/575),多无症状(80.2%),甲胎蛋白检查均正常。病灶多为单发(91.8%)。B超检查76.2%(294/386)的病灶为低回声。CT动态扫描93.7%(532/568)增强后早期明显强化,出现中央星状瘢痕114例(20.1%)。MRI检查87.4%(334/382)早期明显强化,出现中央星状瘢痕102例(26.7%)。行手术切除416例,无手术死亡及严重并发症。结论FNH在影像学上有一定的特征性改变,结合临床及各种影像检查资料可提高诊断率。
Objective To investigate the clinical features and diagnostic methods of focal nodular hyperplasia (FNH) in the liver. Methods Eighty-five articles about FNH published in China’s open journals in the past 20 years from 1988 to 2007 and 12 cases of FNH confirmed by postoperative pathology in the past 6 years were retrospectively reviewed analysis. Results FNH more common in patients aged 20 to 50 years, average 35.4 years old, male to female ratio 1.22:1.00 (700/575), asymptomatic (80.2%), a fetoprotein examination were normal. Mostly single lesions (91.8%). B-ultrasound 76.2% (294/386) of the lesions were hypoechoic. CT dynamic scan 93.7% (532/568) enhanced significantly enhanced early, there were 114 cases of central stellate scar (20.1%). In 87.4% (334/382) of MRI examinations, there were 102 cases (26.7%) of central astrocytes. Surgical resection of 416 cases, no operative mortality and serious complications. Conclusion FNH has some characteristic changes in the imaging, combined with clinical and various imaging examination data can improve the diagnostic rate.